The long-term prognosis for severe damage to weight-bearing cartilage in the knee: A 14-year clinical and radiographic follow-up in 28 young athletes

Messner, Karola; Maletius, Wolfgang

doi:10.3109/17453679608994664

Cited by 394 publications

(227 citation statements)

References 12 publications

Supporting

Mentioning

204

Contrasting

Unclassified

Order By: Relevance

“…This information coincides with the literature. In a multicentric study by the European Society for Childrens' Orthopaedics, the ratio was 2:1 in 798 cases [9,19]. We were unable to ascertain a marked side difference.…”

Section: Discussionmentioning

confidence: 71%

Long-term results after operative treatment of osteochondritis dissecans of the knee joint—30 year results

Michael

Würth

Eysel

et al. 2007

International Orthopaedics (SICO

View full text Add to dashboard Cite

Osteochondritis dissecans (OD) mostly appears at the knee joint on the weight-bearing part of the medial femoral condyle. A multi-factorial event is most likely responsible for the triggering of OD. The aim of this retrospective study was to carry out long-term assessment of the results of operative treatment. Between 1959 and 1976, 148 patients were treated for OD by an open technique. For this purpose, a total number of 38 patients were analysed after approximately 30 years. Twenty-six patients were evaluated clinically by means of standardised questionnaires and also radiologically; 12 patients were analysed only by questionnaire. In order to verify the clinical findings and the subjective assessment, radiographs were done and analysed according the Kannus score. The Brückl score was used to evaluate the results of the OD. Twenty-four knee joints were analysed by radiographs. Sixty percent of the operated joints showed poor results in the analysis according to Kannus. Only four patients showed an excellent result by using the clinical scoring system. Nevertheless, we were able to prove a markedly higher rate of osteoarthrosis. The causal explanation for this lies in the patient selection. Most of the patients were above average age, and the OD was discovered quite late, and thus the disease had already progressed to a higher degree. In 74% of all cases, an extirpation of the osteochondral fragment was performed, whereas today there are several operative options. In our view, therefore, the need arises to conduct further followup examinations with comparative time spans, as well as to conduct a parallel analysis of corresponding control groups in order to evaluate the aetiology of the increased rate of osteoarthrosis.Résumé L'ostéochondrite disséquante (OD) est habituellement localisée, au niveau de l'articulation du genou, sur la surface portante du condyle médial, son déclenche-ment est souvent multifactoriel... Le but de cette étude rétrospective est d'évaluer à long terme le traitement. Entre 1959 et 1976, 148 patients ont été opérés d'une ostéochondrite disséquante par voie sanglante 38 patients ont été analysés après 30 ans d'évolution. Vingt-six patients ont été évalués cliniquement après un questionnaire standardisé et une radio; 12 patients ont été évalués simplement par questionnaire. Afin de vérifier les élé-ments cliniques et l'évaluation subjective, des radios ont été faites et analysées avec le score de Kannus. Le score de Brückl a été utilisé pour évaluer les résultats de l'ostéochondrite disséquante. Vingt-quatre genoux ont été analysés radiographiquement; 60% des genoux opérés montraient un mauvais résultat selon le score de Kannus. Seulement 4 patients ont montré un excellent résultat. Néanmoins, nous pouvons affirmer que ces patients présentent un taux important de gonarthrose. L'explication causale de ces résultats vient du choix des patients. La plupart des patients ont été diagnostiqués à un âge moyen élevé et, l'ostéochondrite découverte tard. Dans 74% des cas, l'ablation du séq...

show abstract

Section: Discussionmentioning

confidence: 71%

Long-term results after operative treatment of osteochondritis dissecans of the knee joint—30 year results

Michael

Würth

Eysel

et al. 2007

International Orthopaedics (SICO

View full text Add to dashboard Cite

show abstract

“…While focal ICRS grade IV lesions of the human knee can be asymptomatic, 16 they cause substantial pain and functional impairment with moderate frequency. 2,[17][18][19] An important subset of affected patients are people of middle age.…”

Section: Discussionmentioning

confidence: 99%

Safety of, and biological and functional response to, a novel metallic implant for the management of focal full‐thickness cartilage defects: Preliminary assessment in an animal model out to 1 year

Kirker‐Head

Sickle

et al. 2006

Journal Orthopaedic Research

View full text Add to dashboard Cite

Focal full-thickness cartilage lesions of the human medial femoral condyle (MFC) can cause pain and functional impairment. Affected middle-aged patients respond unpredictably to existing treatments and knee arthroplasty may be required, prompting risk of revision. This study assesses the safety of, and biological and functional response to, a metallic resurfacing implant which may delay or obviate the need for traditional arthroplasty. The anatomic contour of the surgically exposed MFC of six adult goats was digitally mapped and an 11 mm diameter full-thickness osteochondral defect was created. An anchor-based Co-Cr resurfacing implant, matching the mapped articular contour, was implanted. Each goat's contralateral unoperated femorotibial joint was used as a control. Postoperative outcome was assessed by lameness examination, radiography, arthroscopy, synoviocentesis, necropsy, and histology up to 26 (n ¼ 3) or 52 (n ¼ 3) weeks. By postoperative week (POW) 4, goats demonstrated normal range of motion, no joint effusion, and only mild lameness in the operated limb. By POW 26 the animals were sound with only occasional very mild lameness. Arthroscopy at POW 14 revealed moderate synovial inflammation and a chondral membrane extending centrally across the implant surface. Radiographs at POWs 14 to 52 implied implant stability in the operated joints, as well as subchondral bone remodeling and mild exostosis formation in the operated and contralateral unoperated joints of some goats. By POW 26, histology revealed new trabecular bone abutting the implant. At POWs 26 and 52 MFC cartilage was metachromatic and intact in the operated and unoperated femorotibial joints. Proximal tibiae of some operated and unoperated limbs demonstrated limited subchondral bone remodeling and foci of articular cartilage fibrillation and thinning. The chondral membrane crossing the prosthesis possessed a metachromatic matrix containing singular and clustered chondrocytes. Our data imply the safety, biocompatibility, and functionality of the implant. Focal articular damage was documented in the operated joints at POWs 26 and 52, but lesions were much reduced over those previously reported in untreated defects. Expanded animal or preclinical human studies are justified. ß

show abstract

“…Once begun, cartilage degeneration cannot be reversed but will tend to progression [8,35], following its own course and becoming independent of the original cause. Unless corrected, this process can undermine and even reverse the clinical outcome of the surgical realignment and eventually impair patellofemoral joint function [45].…”

Section: Introductionmentioning

confidence: 99%

Distal realignment and patellar autologous chondrocyte implantation: mid-term results in a selected population

Gigante

Enea

Greco

et al. 2008

Knee Surg Sports Traumatol Arthr

View full text Add to dashboard Cite

The aim of this prospective observational study was to assess the 3-year clinical outcome of distal realignment and membrane-seeded autologous chondrocyte implantation (MACI Ò ) in selected patients with patellofemoral malalignment and large, isolated, patellar cartilage lesions. Twelve patients (14 knees; 6 females, 6 males; mean age 31 years) with Fulkerson type II patellofemoral malalignment (lateralized and tilted patella) and Outerbridge grade III-IV isolated patellar cartilage lesions were treated. All had tibial tuberosity and trochlear sulcus [20 mm on a preoperative CT scan and a cartilage defect

show abstract

The long-term prognosis for severe damage to weight-bearing cartilage in the knee: A 14-year clinical and radiographic follow-up in 28 young athletes

Cited by 394 publications

References 12 publications

Long-term results after operative treatment of osteochondritis dissecans of the knee joint—30 year results

Long-term results after operative treatment of osteochondritis dissecans of the knee joint—30 year results

Safety of, and biological and functional response to, a novel metallic implant for the management of focal full‐thickness cartilage defects: Preliminary assessment in an animal model out to 1 year

Distal realignment and patellar autologous chondrocyte implantation: mid-term results in a selected population

Contact Info

Product

Resources

About